Lung cancer, confirmation of efficacy for target therapy

Lung cancer, confirmation of efficacy for target therapy

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The benefits of this molecule, in combination with chemotherapy, had already emerged a year ago, when osimertinib was shown to improve progression-free survival in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring mutations of the epidermal growth factor receptor (EGFRm). Now another good news comes from the European Lung Cancer Congress, which has just ended in Prague: osimertinib in combination with chemotherapy is able to offer a clinical benefit consistent with post-disease progression outcomes. At a two-year follow-up, a favorable trend in the improvement of overall survival was also observed.

An underestimated number of patients

Worldwide there are approximately 600 thousand new diagnoses of non-small cell lung cancer with EGFRm mutations. In Italy, however, in 2023, approximately 44 thousand patients with lung cancer were estimated, of which 85% with NSCLC, among which 10-20% with EGFRm mutations. But because it is estimated that only 76% of patients with adenocarcinoma (the type of NSCLC most frequently associated with EGFRm mutations) are tested for the presence of these mutations, the actual number of patients with EGFRm NSCLC may be underestimated.

A benefit for all patients

The news that comes from the European event is the result of an interim analysis of the Phase III FLAURA2 study, which demonstrates not only the benefit of the combination but also that it remains so in the various subgroups considered, which include sex, ethnicity, type of EGFR mutation, age at diagnosis, smoking history, performance status and type of central nervous system metastasis at study recruitment.

“The improvement in post-progression outcomes with the addition of chemotherapy to the first-line standard of care represented by osimertinib, highlighted in the FLAURA2 study, is encouraging. And the consistent and favorable trend in overall survival observed with follow-up is particularly encouraging. up to 2 years”, comments Filippo de Marinis, Director of the Division of Thoracic Oncology of the European Institute of Oncology (IEO) in Milan. “These results reinforce the efficacy already demonstrated by osimertinib in monotherapy with the FLAURA study and further attest to the importance of this therapeutic option.”

Good safety profile

The safety profile of osimertinib in combination with chemotherapy was in line with expectations, with the majority of adverse events occurring at the start of chemotherapy treatment. Analysis of patient-reported outcomes (PROs) showed improvement in health-related quality of life and symptoms such as dyspnoea, chest pain and cough.
Osimertinib is being studied in other settings, including neoadjuvant and resectable adjuvant, to confirm its benefit in the treatment of EGFRm NSCLC.

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